HomeMy WebLinkAbout0038147-Electric 4/1
CITY OF OSHKOSH N2 38147
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS o / O PLAN NO.
��� ,L
OWNER /L7JK/trr /��cc
DESIGNER
USE /NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New X Change ❑ Temp ❑ Type I 07 Volts 3 Amps j_0?.
Fixtures Switches Receptacles Circuits
•
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ oD O 0 . 0 o Permit Fee Paid $ 579. 0 a ✓ Park Dedication $
ISSUED BY /1444" Date 0-'419 Se Final /O.P. Si"- 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 3k0 . APPL . DATE /404‘
ELEC. CONTR. 6. t /arc /
OWNER j /
ADDRESS 3i a/ 44-eiajd
NATURE OF WORK EE 7 /g _
ELEC. SERV. /N CHANGE
DESC. TYPE c TEMP , ,�
VOLTS AMPS yep
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
IGN
NSP. ROUGH N . IffarAMMOMNIMSNIMUMAMIgRZORIM
EST. COST . .. o o PERMIT FEE 5"0 a7 DATE PD.Z f t
REMARKS